Chronic Kidney Disease Diet: What You Need to Know
Nutrition plays a crucial role in managing kidney disease, a condition affecting 1 in 7 people in the United States. While diet can significantly slow disease progression and preserve kidney function, many patients face confusion and frustration when trying to navigate their nutritional needs.
Much of this stems from outdated and conflicting information online, where guidance like avoiding all potassium-rich foods or sticking to white rice still circulates despite advances in research. This mixed messaging often leaves patients feeling overwhelmed and afraid to eat.
Sara Prato, a dietitian who specializes in chronic kidney disease, has dedicated her career to helping people with kidney disease cut through the noise. With over a decade of experience, she combines evidence-based nutrition with a holistic approach, focusing on stress management, exercise, sleep, and behavior change.
Through her practice and educational programs, Sara empowers patients to make informed dietary choices, giving them the tools they need to take control of their kidney health.
The Impact of Nutrition on Kidney Disease
The kidneys play a vital role in filtering waste from the blood and maintaining the balance of electrolytes in the body. Each kidney contains millions of nephrons, the tiny filtering units responsible for this essential function. However, once nephrons are damaged, they cannot regenerate. This makes it crucial to preserve kidney function as much as possible.
Nutrition is one of the most powerful tools for slowing the progression of kidney disease. By reducing the workload on the kidneys, a well-designed diet can help maintain function and delay the need for dialysis or a transplant. For example, managing sodium intake supports blood pressure control, while adjusting protein, potassium, and phosphorus levels can reduce strain on the kidneys. As Sara explains, "Nutrition is always very powerful and even more so in kidney disease in early stages."
Unfortunately, many patients are unaware of the impact nutrition can have until their kidney function is significantly reduced. As Sara shares, "People often don't know they have any risk factors or kidney disease because it's not something that's talked about regularly, unlike other chronic conditions like heart disease and diabetes." Because of this, patients often don't realize the importance of preserving their kidney function until the disease has progressed to a later stage.
Navigating Conflicting Information Online
Once patients do get a kidney disease diagnosis and realize the importance of nutrition, they often turn to Google to learn more. But, they then run into a new challenge: navigating the abundance of outdated and conflicting information online. "They start looking online because they're scared," Sara explains. "They don't want to damage their kidneys or end up on dialysis, so they search online and find a mix of outdated and current information."
"You'll find one website that says you can only eat white rice, and another that says whole grains are fine. One says to avoid all potassium, while another says to eat lots of fruits and vegetables," Sara shares. "Patients become so confused that they start restricting many foods out of fear of making things worse."
In addition to conflicting advice about food, patients often encounter advertisements for cleanses, detoxes, and so-called "natural remedies" that promise to restore kidney function. Sara warns against these products, which are often not backed by science and can even be harmful. "There are people out there preying on scared and confused patients," she says. "I'm very much in favor of holistic and natural approaches, but detoxes and cleanses won't restore kidney function, and they can even be harmful."
This misinformation leaves many patients overwhelmed, stressed, and unsure of what to eat. Sara works to unravel these myths and provide patients with clear, evidence-based guidance tailored to their individual needs. "I want to help people take a breath, understand what they can eat, and feel confident nourishing their bodies without fear," she says. By addressing these misconceptions, Sara empowers her patients to make informed, sustainable dietary choices that truly support their kidney health.
Key Nutritional Strategies for Kidney Health
The right nutritional strategy for managing kidney disease depends on the individual and their stage of the disease. As Sara emphasizes, "Every patient is different, and their diet needs to align with their unique circumstances and kidney function." Working with a kidney dietitian who can tailor recommendations to the individual can help patients get the best possible outcomes.
Here are some strategies that might be used, depending on the individual and their disease progression:
Reduce sodium intake
For patients in earlier stages of kidney disease, reducing sodium intake is often a priority to control blood pressure, one of the leading causes of kidney damage. "Excess sodium increases blood pressure, which puts additional strain on the kidneys," Sara explains. However, the degree of sodium restriction may vary depending on an individual's blood pressure and overall health.
Incorporate more plant-based foods
Plant-based diets can be kidney-friendly, but they must be adapted to the patient's specific needs and stage of kidney disease. In earlier stages, incorporating more fruits, vegetables, and whole grains may help reduce inflammation and support kidney health. "Plant-based foods can be very beneficial, but the approach needs to be balanced, especially if potassium levels are a concern," Sara notes.
Balance potassium and phosphorus
Potassium and phosphorus management becomes increasingly important as kidney disease progresses. Patients in earlier stages may not need strict restrictions, but those with lower kidney function may need to monitor their intake more closely. "It's all about balance," Sara explains. "We look at lab results and tailor the diet to what each patient's kidneys can handle safely."
Determine protein needs
Protein needs also change depending on the stage of kidney disease. "In early stages, we often reduce protein intake to ease the burden on the kidneys," Sara says. But for patients on dialysis, protein needs actually increase because dialysis removes protein waste from the blood.
Behavior Change and Holistic Health
Nutrition is only one piece of the puzzle when it comes to managing kidney disease. A truly effective approach involves looking at the whole person and addressing other key aspects of health, such as stress management, exercise, and sleep.
"Stress can impact blood pressure and other factors that affect kidney health, so it's important to address it," Sara shares. Sara encourages her patients to explore stress-reducing practices like mindfulness, meditation, or even simple breathing exercises to create a sense of calm.
Regular physical activity is another cornerstone of kidney health. Exercise helps with weight management, improves cardiovascular health, and supports better blood pressure control—all of which are critical for protecting kidney function.
Quality sleep is equally important but often overlooked. Poor sleep can contribute to high blood pressure, increased stress, and even worsen chronic conditions like diabetes, which are major risk factors for kidney disease. Prioritizing a consistent sleep schedule, reducing screen time before bed, and creating a restful sleep environment can improve both physical and mental well-being.
Sara also emphasizes that lasting change comes from personalization and sustainability. "Knowing information doesn't equal change," she explains. "It's about breaking things down into small, manageable steps that feel achievable." Whether it's gradually reducing sodium intake, introducing one new plant-based recipe per week, or starting with just 10 minutes of daily exercise, the focus is on building habits that last.
By addressing these lifestyle factors alongside nutrition, Sara helps patients take a holistic approach to managing kidney disease. This integrated strategy not only supports kidney health but also improves overall quality of life, empowering patients to feel their best while navigating their condition.
Resources for Kidney-Friendly Nutrition
For reliable, up-to-date information, reputable resources are essential. Sara recommends the National Kidney Foundation including their CKD Dietitian Directory and the American Kidney Fund as starting points. These organizations provide valuable guidance on managing kidney disease through diet and lifestyle.
Additionally, Sara is developing an online program, KidneyClarity™, an online program designed with patient input to make kidney nutrition education more accessible. It will offer self-paced modules and group options to help individuals manage their kidney health. When KidneyClarity™ launches, it will be paired with the Kidney Kindness Fund, which will provide financial support to those in need with no proof required, just an invitation to share their story. By working with Sara, clients help others access vital kidney education, building a community of support, awareness, and positive change. This is her way of paying it forward and making a meaningful impact in kidney care.
Sara Prato, aka The CKD Dietitian, is a Registered Dietitian Nutritionist, specializing in kidney nutrition. Her mission is to guide individuals on their personal path towards better kidney health and overall well-being.